National Provider Identifier [NPI]: |
1730187576 |
Last Name Of The Provider |
MANDELL |
First Name Of The Provider |
IRA |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
25 CROSSROADS DR |
Street Address 2 Of The Provider |
SUITE 205 |
City Of The Provider |
OWINGS MILLS |
Zip Code Of The Provider |
211175421 |
State Code Of The Provider |
MD |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Nephrology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
35 |
Number Of Services |
6380 |
Number Of Medicare Beneficiaries |
854 |
Total Submitted Charge Amount |
1195072.72 |
Total Medicare Allowed Amount |
477504.76 |
Total Medicare Payment Amount |
358832.53 |
Total Medicare Standardized Payment Amount |
346819.11 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
2 |
Number Of Drug Services |
2950 |
Number Of Medicare Beneficiaries With Drug Services |
79 |
Total Drug Submitted ChargeAmount |
84853.79 |
Total Drug Medicare AllowedAmount |
33938.59 |
Total Drug Medicare PaymentAmount |
24982.14 |
Total Drug Medicare Standardized Payment Amount |
24982.14 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
33 |
Number Of Medical Services |
3430 |
Number Of Medicare Beneficiaries With Medical Services |
854 |
Total Medical Submitted Charge Amount |
1110218.93 |
Total Medical Medicare Allowed Amount |
443566.17 |
Total Medical Medicare Payment Amount |
333850.39 |
Total Medical Medicare Standardized Payment Amount |
321836.97 |
Average Age Of Beneficiaries |
71 |
Number Of Beneficiaries Age Less65 |
208 |
Number Of Beneficiaries Age 65 to 74 |
278 |
Number Of Beneficiaries Age 75 to 84 |
233 |
Number Of Beneficiaries Age Greater 84 |
135 |
Number Of Female Beneficiaries |
406 |
Number Of Male Beneficiaries |
448 |
Number Of Non Hispanic White Beneficiaries |
297 |
Number Of Black or African American Beneficiaries |
536 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
612 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
242 |
Percent Of With Atrial Fibrillation |
23 |
Percent Of With Alzheimers Disease or Dementia |
22 |
Percent Of With Asthma |
11 |
Percent Of With Cancer |
14 |
Percent Of With Heart Failure |
58 |
Percent Of With Chronic Kidney Disease |
75 |
Percent Of With Chronic Obstructive Pulmonary Disease |
23 |
Percent Of With Depression |
27 |
Percent Of With Diabetes |
65 |
Percent Of With Hyperlipidemia |
75 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
65 |
Percent Of With Osteoporosis |
6 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
38 |
Percent Of With Schizophrenia Other PsychoticDisorders |
9 |
Percent Of With Stroke |
14 |
Average HCC Risk Score Of Beneficiaries |
4.822 |